Op-Ed: doctor vs. trainer

Turns out the two don't talk. Here's why it can hurt your recovery, and how to fix it.

The likelihood of injury among athletes and those who lead fitness-centric lifestyles is relatively high. When that happens, we expect healthcare experts to evaluate us holistically and within the context of our individual lives, whether that means getting back to marathon training ASAP, or being in good enough shape for a summer hiking trip. Yet that is hardly the case. The circle of care is often fragmented, leading to multiple visits to the orthopedist and physical therapy referrals with no clear plan for communication between providers. Patients are left to sift through conflicting treatment plans. Personal trainers––the people who know clients the best––are often excluded from the conversation.

As a doctor-in-training and certified trainer, I’ve seen both sides. I’ve worked with injured athletes, I’ve trained them and I’ve been one myself. The current, circuitous treatment pathway results in slower recovery times, inferior health outcomes and a significant misuse of healthcare spending. It's a frustrating experience. Part of it traces back to underlying distrust between the two sides. Doctors tend to think that trainers aren't as equipped to treat injury (or, worse, contributed to the cause). And trainers accuse doctors of too-often resorting to invasive measures rather than recovery through modified exercise and strength training.

The need for collaborative care is undeniable. Even though the majority of doctors-in-training believe that physical activity prescription is vital, a review of research in the Journal of Physical Activity and Health suggests that over half of US physicians trained in 2013 received no formal education in the area of physical activity and a meager 28 percent of internal medicine residents felt confident in their ability to prescribe it.

Fortunately, there are practitioners making big moves to change the game. This new model proposes a collaborative, team-based approach. “We’ve eliminated conflicting therapy by working directly with our patients’ trainers,” says Dan Giordano, a New York-based physical therapist and trainer. “Because of this collaboration, we’re seeing our patients recover at astonishing rates and with less time and money being wasted with unnecessary treatment.”

Some doctors are experimenting with crossing over into the training sphere, for both injury treatment and prevention. “I've become a part-time trainer too because I've realized that just telling people to exercise isn't enough," says Jordan Metzl, MD, a sports medicine physician at The Hospital for Special Surgery in New York.

The benefit of the doctor-trainer relationship is obvious. “I see trainers as extension of what happens in my office," Metzl says. "In the best of all worlds, I help fix their injuries and then I work with their trainer to keep them on the path of strength and prevention. The closer the worlds of medicine and fitness become, the better for everyone involved.”

Oftentimes, though, the trainer-doctor relationship is initiated not by doctors, but by training programs. Matt Delaney, CSCS and Equinox Tier 4 trainer believes, “Collaborative teams are definitely the future of holistic wellness. If you really care about helping people get better, then this is how you do it.” This forward type of thinking that integrates medicine, physical training, and any other relevant specialty is the key differentiator between getting by and functioning at peak performance.

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